23D0926444 CLIA NUMBER - PLASTIC SURGERY ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 23D0926444
  • Facility Name: PLASTIC SURGERY ASSOCIATES, PC
  • Facility Address: 220 LYON STREET NW SUITE 600
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 451-4500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DOUGLAS A. VANDER WOUDE
  • NPI Number: 1093899767
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 23D0926444
LAB Type Ambulatory Surgery Center
Facility Name PLASTIC SURGERY ASSOCIATES, PC
Street 220 LYON STREET NW SUITE 600
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 451-4500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Ambulatory Surgery Center
Lab Director DOUGLAS A. VANDER WOUDE

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This page was last updated on: 9/29/2025